Individual provider Active NPI

Jill Leabman, CCC-SLP

  • Speech-Language Pathologist
  • Philadelphia, PA
National Provider Identifier
1336681360
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL013208 Issued in PA
Practice address
1003 Spruce St
Apartment 2R
Philadelphia, PA 19107-6711
Phone
(860) 539-8243
NPI assigned
Nov 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL013208 PA Primary
Speech-Language Pathologist 235Z00000X 010001547 DE

Addresses

Primary practice location

1003 Spruce St
Apartment 2R
Philadelphia, PA 19107-6711

Mailing address

1003 Spruce St
Apartment 2R
Philadelphia, PA 19107-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
010001547DEMDSpeech-Language Pathologist
SL013208PAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1336681360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 SPRUCE ST",
            "address_2": "APARTMENT 2R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SPRUCE ST",
            "address_2": "APARTMENT 2R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076711",
            "telephone_number": "860-539-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEABMAN",
        "first_name": "JILL",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL013208",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DE",
            "license": "010001547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.